Abstract:

A diagnosis of cancer causes certain fears to arise in a patient, as well as among his family, activating intense emotional responses in everyone concerned. Examples of such emotions are anger, self-reproach, guilt, heartache, helplessness and mourning. An acceptance of the circumstances does not necessarily occur, and the phases of the mourning process may be continually interchanging. The purpose of this study was to explore and describe the following: the contribution made by psychiatric nursing accompaniment through the medium of a psychiatric nursing specialist, as regards lessening the mental discomfort of the family of a patient being treated in an oncoloty unit or at home. A further purpose was to set certain guidelines for the registered nurse, concerning her support of the family of a patient in an oncology unit or at home, thereby lessening their mental discomfort. An exploratory, descriptive, contextual study was done on a family with one member who had been diagnosed with cancer, and who received treatment in an oncological unit and at home. This family submitted themselves to psychiatric nursing accompaniment. A purposive, non-selective accompaniment. A purposive, non-selective sample was used and the family had to satisfy certain specific criteria pertaining to mental discomfort. The case study method was followed for exploring and describing the process of psychiatric nursing accompaniment. The unit for this study was the family of a patient with cancer. Each session of psychiatric nursing accompaniment was recorded on audio tape and literally transcribed. Field notes concerning impressions, perceptions and observations of the psychiatric nursing accompaniment and served to supplement the transcriptions. A case record, composed from the literature overview directed the accumulation and interpretation of data. Specific steps in the nursing process and the phases of the psychiatric nursing accompaniment were used as guidelines for the process of gathering data. Content analysis was done using a modified combination of Kerlinger and Girogi's methods. During this study it was found that a change did occur under psychiatric nursing accompaniment. This change consisted mainly of a fluctuation between an increase and a decrease in the mental discomfort experienced by the family. Mental discomfort still existed, owing to the recurring theme of cancer which could not be excluded from the family's environment. As a result, a plateau phase was reached by the family. Psychiatric nursing accompaniment could therefor be used as a method of ineraction with the family of a patient in an oncological unit or at home. During the plateau phase, however, it became necessary that certain aspects of support be built into the process and that the process be extended over a longer period of time, to accommodate the needs of the family. During a process of psychiatric nursing accompaniment it would be necessary to address certain obstacles which might appear, such as unrealised crises, mourning and defence mechanisms. The possibilities for applying the study's findings were provided for nursing practice, research and education. Specific guidelines were formulated for the registered nurse to enable her to support the family of a patient diagnosed as suffering from cancer, and thereby reduce their mental discomfort.